This paper assessed student’s perceptions of water and sanitation challenges and explored adaption measures of inadequate access and utilization of water supply and sanitation facilities in East African Universities from a gender perspective. Cross-sectional gender focused study design was adopted. Seven hundred and one (701) respondents were interviewed at Makerere University and University of Dar es salaam. Gender disaggregated data was collected using semi-structured and in-depth interviews, focus group discussions and site observations. The gender perspectives based frameworks were used to generate gender inequality insights and reflections. Majority of male and female students agreed that there are gender differences in access and utilization of water and sanitation facilities, female students being the most affected. Several adaptation measures are used by students in accessing and utilizing water and sanitary facilities including moving to other locations with water supply and sanitary facilities, buying water including for drinking, collecting water from unhygienic sources and storing water.
